Who are pediatric allergists?
Pediatric allergists or pediatric immunologists are medical doctors who study children's allergic and immunologic disorders. They diagnose and treat pediatric patients for such conditions.
The immune system helps the human body fight infections. Allergies are situations in which the immune system recognizes harmless particles as foreign bodies and invokes the fight response within the body. Common allergens in children include pollen, pet dander, insect stings, dust, certain foods, medications, and mold spores.
The allergic reaction in kids can be mild or severe. Mild reactions include hives, eczema (rashes), and hay fever. Severe reactions occur as anaphylaxis, a life-threatening allergic reaction that develops within minutes of exposure to the allergen. Patients can die if not treated on time. Kids with defective immune systems are prone to many infections, such as pneumonia, sinusitis, abscesses, and thrush.
Training for pediatric allergists in the U.S.
After finishing four years of an undergraduate degree in a related field, people interested in becoming pediatric allergists must begin their journey by completing four years of medical school. Doctors must then finish three years of residency focusing on pediatrics. To be called a pediatric allergist or pediatric immunologist, doctors must complete an allergy and immunology program, which takes two to three years.
The American Board of Allergy and Immunology (ABAI) is the official organization in the U.S. that provides board certification to pediatric allergists.
What conditions do pediatric allergists treat?
Pediatric allergists treat any condition that develops as an immunological response to harmless external stimuli. Some of the most common ones are as follows:
- Asthma: Asthma is a chronic condition that attacks the lungs. During an asthma attack, there is a restriction in the airflow through the airways; the tightening of the muscles around the airways causes this. Other signs of an asthma attack include swelling in the lining and increased mucus production. Patients having asthma attacks complain of breathing difficulties, coughing, wheezing, pain in the chest, and shortness of breath. Allergies to pollen, dust mites, air pollutants, molds, and pet dander are common causes of an asthma attack. Childhood asthma usually begins at age five, and pediatric allergists are the perfect healthcare professionals to diagnose and treat asthma attacks in kids. Treatment for asthma includes medications and inhaler therapy. Failure to treat asthma episodes promptly can lead to fatalities.
- Hay fever: Hay fever, medically known as allergic rhinitis, is a condition that usually occurs during seasons with excessive pollen in the air. Kids allergic to pollen develop swelling in the lining of the nose and eyes, which leads to allergic reactions in their bodies. The symptoms can be mild, such as rashes, itchy eyes, runny nose, sneezing, and trouble breathing. Severe allergic reaction presents as anaphylaxis. Anaphylactic shock leads to sudden constriction of the airways and a drop in blood pressure, which can be life-threatening if not managed on time. Treatment for allergic rhinitis uses oral medications and immunotherapy.
- Food allergies: Food allergies are widespread in children and present as an extreme immune response to certain foods. Common foods that cause allergies in kids include milk, eggs, fish, peanuts, soy, wheat, shellfish, and tree nuts. Food allergies may include swelling in eyelids, lips, and tongue, rashes on the skin, shortness of breath, and problems with swallowing, to severe issues, such as abdominal pain, diarrhea, loss of consciousness, and anaphylaxis.
- Hives and swelling: Urticaria and angioedema often appear as part of an allergic reaction. In simple terms, urticaria refers to hives, the red raised dots found on the skin, and angioedema refers to swelling of the tissues under the skin. When airways get blocked and there is swelling in the throat, it can lead to death. These reactions occur in response to pollen, molds, pet dander, peanuts, milk, tree nuts, eggs, fish, medications such as NSAIDs, blood pressure medicines, ACE inhibitors, and materials such as detergents and latex. These reactions can also be a result of autoimmune conditions in the patients. Skin and blood tests diagnose the cause of these reactions, and the treatment includes allergy medications, shots, and oral steroids.
- Primary immunodeficiency disorders (PIDD) are inherited immune conditions that impair a person's immune system, making them vulnerable to infections and other severe complications. While most PIDDs are not fatal, early diagnosis and treatment are necessary to prevent life-threatening complications. Children born with Primary Immunodeficiency Disorder (PIDD) have a faulty immune system that cannot combat infections due to problems with white blood cells, including T and B lymphocytes. As a result, they are more prone to getting sick quickly and remaining ill for longer than other children. Additionally, even harmless organisms can cause infections in these children.
What to remember when dining out with a child with a food allergy?
Dining out presents its own set of challenges when you have a child with food allergies. But worry not—if you're prepared and persistent, you can ensure your child has a pleasant and healthy experience.
Here's how pediatric allergists suggest navigating dining out with food allergies:
- Research the restaurant: Before heading out, familiarize yourself with the restaurant's menu and ingredient lists. Grab a menu in advance and review it thoroughly.
- Communicate clearly: Inform your server about your child's allergies right away. They should know how each dish is prepared and what ingredients are used. Feel free to ask questions about preparation methods and ingredients. If your server needs clarification, request to speak with the manager or chef.
- Avoid specific setups: Steer clear of buffet-style or family-style dining, as cross-contamination risks are higher with shared utensils.
- Be wary of fried foods: Fried items may share the same oil, posing a risk of cross-contact. It's best to avoid them altogether.
- Use food allergy cards: Consider providing your server or manager with a food allergy card detailing your child's allergies and any necessary precautions. You can easily print these cards at home or obtain them online. If your child is dining out without you, ensure they have a card to give to the server.
- Explore online resources: Investigate internet resources like the Food Allergy Buddy Dining Card, which allows you to customize it with your child's specific allergies and information.
- Look for certified training programs: Seek out restaurants that have undergone food allergy training programs, such as the one offered by the Food Allergy Initiative in partnership with organizations like the National Restaurant Association. These programs help ensure that restaurants can accommodate customers with food allergies safely and effectively.
Does your child require allergy testing?
According to experts, if your child experiences allergy-like symptoms such as a sore throat, watery eyes, or a stuffy nose—especially after playing outside or exposure to a specific food or product—it's recommended that you consult an allergist.
Pediatric allergists must perform allergy testing for any child experiencing nasal allergies not controlled by medications, asthma, hives, recurrent sinus infections, eczema, or possible food allergies to determine the root cause behind their allergic problems.
Although allergy testing can be performed at any age, it is recommended for children six months or older.
What diagnostic tests do pediatric allergists perform?
The following are some of the diagnostic tests that pediatric allergists near you may perform:
- Skin prick test: It is the most widely used method for allergy diagnosis. In this test, the doctor places a drop of the suspected substance causing the allergy and then scratches the skin's surface in that area. The allergy diagnosis is affirmative if the patient develops itching and hives. The pediatric allergist performs the intradermal skin test to confirm the diagnosis in cases where the skin prick test turns negative.
- Intradermal skin test: During this test, the physician injects the suspected allergen subcutaneously through the outer layer of the skin and waits to check for signs of allergic reaction in that area.
- Blood tests for allergy: These tests diagnose allergies in young children as they cannot tolerate skin tests. The doctors draw a blood sample from the kid, mix it with the allergen, and measure the number of antibodies in the laboratory.
- Challenge tests for allergy: Under the doctor's supervision, the patient inhales or ingests a small amount of the allergen. The healthcare provider records and measures the changes to determine the allergy diagnosis. These tests help diagnose medication and food allergies.
- Patch test: This is the most common test to diagnose contact dermatitis. The doctors set a small amount of the suspected allergen on the skin and covered the area with a bandage. After 2 to 4 days, they remove the plaster and record the reaction.
Preparing for a visit with a pediatric allergist
If your child is experiencing unusual symptoms like a runny nose, itchy throat, or reduced energy, it may be time to consult a doctor. Preparing for this visit ensures you get the most out of the consultation.
Track your child’s allergy symptoms
Keeping a record of your child’s symptoms before the appointment can provide valuable insights when visiting a pediatric allergist near you. Pay close attention to the symptoms (e.g., sneezing, congestion, itchy eyes), how they affect your child’s daily activities, when they are most noticeable (e.g., time of day or season), the severity and any possible triggers, and any changes in symptom patterns over time. This information helps the allergist differentiate between allergies and other conditions like colds.
Be ready to answer key questions
To help the doctor understand your child’s condition better, consider the following ahead of the appointment:
- When did the symptoms first start?
- Is there anyone else in your family dealing with allergies?
- What treatments, if any, have you tried?
- Is your child currently taking any medications?
- Do symptoms occur indoors, outdoors, or both?
Prepare your child for the visit
Explain to your child what they might experience during the appointment to ease anxiety. The pediatric allergist may perform different tests that may be deemed necessary. Reassure your child that these tests are simple and focus on helping them feel better.
Questions to ask during the appointment
While at the doctor’s office, make sure to ask questions that address your concerns and clarify the treatment plan, including:
- How can I confirm my child has allergies and not another condition?
- Are there specific allergens that make symptoms worse?
- Will symptoms reappear, and how can I identify them early?
- Is it possible for my child’s allergies to improve or resolve over time?
- What changes can I make at home to help manage symptoms?
- Should we consult an allergy specialist for ongoing care?
Anaphylaxis in children
Anaphylaxis is an acute, life-threatening response to an allergen. It is a medical emergency. Your child can have an allergic reaction within seconds or an hour after contact.
Common causes of anaphylaxis include food items, bee stings, medications, dyes for medical tests, allergy shots, or latex. The signs and symptoms of anaphylaxis usually manifest rapidly. These may include:
- Tightness or swelling in their throat, tongue, or uvula (the small, soft pendulum at the back of the throat)
- Intense itching of the skin
- Wheezing or difficulty breathing.
- Abdominal pain
- Nausea and vomiting
- Hives all over the body
- Uneasy feeling or jumpiness
- Loss of bladder control
- Lowered blood pressure
- Irregular heartbeat
- Heart failure
For a pediatric allergist to diagnose a child with anaphylaxis, they require the following information - any known allergies, exposure to any known or possible allergens, symptoms, a physical evaluation, and blood test results (in some instances).
Finding a pediatric allergist near you in New York, NY
Finding children's allergists with the proper training and experience to care for your child's condition may be challenging. Fortunately, with Zocdoc, this process can be simple.
Zocdoc allows you to filter the list of children's allergists in New York based on your needs and requirements: child's condition, date and time of appointment, current location, zip code, and medical insurance. With Zocdoc, you can book in-person or online appointments by filling in a few necessary details in the search boxes. Once you enter these details, the application will automatically filter through the results and present you with the best-suited children's allergists in New York.
To help you make an objective decision, Zocdoc also includes a detailed profile for all pediatric allergists listed on its website. The profile contains the doctor's education and training, clinical experience, certification and licenses, affiliations, accreditations, and accolades. You can filter the list by the doctor's gender, languages spoken, primary age group of specialization, and conditions they have expertise in managing.
Finding the root cause of allergies and the mode of treatment can sometimes take several appointments. Having medical insurance to cover payments helps in saving money. Select your current insurance from the drop-down menu. Zocdoc will immediately inform you which doctors are in-network and will accept your insurance.
If your insurance plan isn't listed on Zocdoc, you can upload a photo of your medical insurance card. Zocdoc will scan the image to identify your likely plan. However, this feature is not available for vision or dental insurance. If you encounter any issues uploading your card or have insurance-related concerns, visit Zocdoc's patient help center.
Booking appointments with pediatric allergists near you using Zocdoc is fast, free, and secure!
Allergy statistics in New York
The New York City Department of Health and Mental Hygiene published a report on the number of emergency visits and hospitalizations caused by asthma. Allergens such as dust mites affect all types of asthma, allergic and non-allergic. In 2017, around 355,000 kids (8.9%) in New York state had asthma. In New York City, 16.1% of high school students had an asthma attack in 2017. The highest numbers were seen in Staten Island (19%), whereas the percentages were lower in Manhattan (16.8%), Bronx (16.5%), Brooklyn (15.5%), and Queens (15%).
The report also stated that the number of emergency department visits for asthma among children in New York State was 150.9 per 10,000 visits in 2014. Hospitalizations due to asthma during the same year were 27.6 for every 10,000 kids between 0 and 17 years.
Another report published by the New York City Department of Health and Mental Hygiene states that, even though children are more likely to be hospitalized for anaphylaxis than adults, they are almost 0% likely to have severe conditions that can lead to death. Crustacean exposure is more likely to lead to hospitalization than exposure to nuts or seeds.
Sources
healthychildren.org
Boston Children's Hospital
Cedars-Sinai
Center for Allergy & Asthma of Georgia
Cleveland Clinic[1]
Cleveland Clinic[2]
Cleveland Clinic[3]
New York State Department of Health
New York City Department of Health and Mental Hygiene
Johns Hopkins Medicine
American College of Allergy, Asthma & Immunology
Claritin
